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Diseases & Conditions : Travel Medicine

Special Vaccination Requirements

Before traveling to any destination outside the United States, it is important to review your vaccination schedule with your doctor. This should be done as far in advance as possible so that any special vaccinations can be scheduled and administered. The CDC recommends that people planning to travel review the vaccines below with their doctor before travel begins.

The primary vaccine series

Review your immunization history with your doctor and be sure that infants and children are on schedule with their vaccine series. Adults should have completed the primary series of all childhood vaccines. A booster of the adult tetanus-diphtheria (Td) is recommended every 10 years. If an adult has not yet received a tetanus booster containing the pertussis (whooping cough) vaccine known as Tdap, he or she should receive that vaccine instead of a Td booster alone. After the one-time administration of the Tdap vaccine, the Td alone every 10 years is appropriate.

What additional vaccines are recommended?

The CDC divides travel vaccines into routine, recommended, and required categories. Your doctor will review all categories with you, specific to the area where you will be traveling.

The following is a list of vaccines to be considered:

The influenza (flu) vaccine is recommended by the CDC for everyone age 6 months and older on an annual basis.

Pneumococcal vaccine is also recommended for people 65 years or older and for other high-risk individuals (those with heart disease, cancer, diabetes, lung problems including asthma, kidney problems, or problems with their immune systems).

For people who have received a complete series of the polio vaccine, those over the age of 18 traveling to areas of the world where polio is still a risk should receive an additional single dose of the vaccine.

Two doses of the measles-mumps-rubella (MMR) vaccine are recommended for people born after 1956 who are traveling outside the United States.

What other vaccinations may be needed?

Yellow Fever vaccination is required for travel to certain countries in sub-Saharan Africa and tropical South America. A certificate of vaccination may also be needed.

Hepatitis B should be considered for people who will be in an area where high rates of hepatitis B exist for more than six months. This includes Southeast Asia, Africa, the Middle East (except Israel), the islands of the South and Western Pacific, some areas of South America, and certain areas in the Caribbean (such as the Dominican Republic and Haiti). Children who have not received this vaccine previously should do so. For those who have completed the primary vaccination series, a booster is not recommended.

Hepatitis A and/or immune globulin (IG) is recommended for travelers to all areas where there is significant risk of hepatitis A, even for travelers staying in urban areas and luxury hotels in those regions. For those who have completed the primary vaccination series, a booster is not recommended.

Typhoid vaccine is recommended for travelers spending time in areas where food and water precautions are recommended, including South Asia (which has some drug-resistant forms) and in developing countries in Asia, Africa, the Caribbean, and Central and South America.

Meningococcal vaccine is recommended for people traveling to sub-Saharan Africa during the dry season (from December to June), and to Saudi Arabia during the Hajj, especially if anticipating close contact with locals.

Japanese encephalitis or tick-borne encephalitis should be considered by those undertaking long-term travel or who plan to live in areas of risk, including rural farming areas.

Rabies vaccination may be needed if you will be in unprotected rural outdoor areas and may be exposed to wild animals.

Currently, the risk of cholera is thought to be low enough that the vaccine is not recommended and is not available in the U.S.

Malaria is prevented with medication that should be started prior to travel. Travelers to countries with malaria are advised to take antimalarial medication.

Many of these vaccines can be given at the same time without any decrease in their effectiveness. Consult your doctor for more information regarding the proper administration of these vaccines and medications.